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Psychological Horror

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If you don't reflect on your life, it might shatter under pressure.
Psychological Horror is a subgenre of Horror that aims at creating horrific, paranoiac, suspenseful or unsettling effects through in-depth use of mental and emotional states or psychological conditions.

This may involve replacing physical threats with psychological ones (e.g. madness, hallucinations), thorough exploration of the mind of the disturbed, mentally ill, or unreliable protagonists (including the bad guys/Monster of the Week), replacing overt displays of horror (monsters, deformed killers) by more subtle, creepy details and an eerie mood or atmosphere that play on the audience's fears. Often overlaps with Surreal Horror.

Often works hand in hand with Nothing Is Scarier, Mind Screw, and Through the Eyes of Madness. Due to the nature of this form of horror, it is usually Nightmare Fuel.

This subgenre is particularly common in Japanese horror, or "J-Horror".

See also Psychological Thriller and Psychosexual Horror.


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    Live-Action TV 
  • American Horror Story: Murder House uses it along with all the Surreal Horror, particularly in Ben's plotlines.
  • Black Mirror: "Playtest" uses a version of this personal to the protagonist. Cooper watched his father succumb to Alzheimer's before the events of the episode, and he went travelling across the world to gather as many happy memories as he could, while he still could. The full-immersion horror game he volunteers to try out for a quick cash injection starts out with tame enough Jump Scares but eventually graduates into this, tormenting him with losing his memory and ending up "just like [his] dad". Then the game throws him a Hope Spot only to present him with the reveal that his mother has contracted Alzheimer's in his absence and she doesn't even recognize him when he returns home. Then it turns out the game never even started and poor Cooper actually died from the system crashing while it was booting up, and the harrowing events of the mansion were all in his head as his brain shut down. You know what they say about your life flashing before your eyes...
  • Doctor Who:
  • Girl from Nowhere
  • Kamen Rider Build explores the depersonalization (even dehumanization at some points) that the Amnesiac Hero Sento Kiryu feels because his identity is haphazardly stitched together from leftover muscle memory and a single year's worth of memories. It only gets worse from here when he finds evidence saying that he has murdered a man, something he would have never done as he is now. And that's before it turns out he is said man and the whole murder scheme was set up to make him disappear and be reused as Unwitting Pawn. The revelations keep on piling up and eventually drive him to suicide.
  • Legion (2017) centers around a mutant who had a diagnosed paranoid schizophrenic who has struggled with mental illness since his late childhood. The series uses Mind Screw to tell a story of psychological horror.
  • Masters of Horror: "Sounds Like" is probably one of the creepier episodes due to the slow-paced source of the horror. There are no monsters or killers to run away from, it's just the main character slowly growing mad because his sense of hearing keeps getting better and better and everything around him becomes intolerable.
  • Moon Knight (2022): A meek London man who works at a museum gift shop suffers from DID and learns that he's a chosen avatar for a god with a giant bird skull for a head.
  • Tends to pop up in The Twilight Zone quite frequently.
  • WandaVision: a magical superheroine accidentally traps an entire suburban town in a sitcom-based alternate dimension built from her own trauma and grief while the government attempts to intervene from outside.

  • "ADDICT" is a song from Hazbin Hotel centering on the troubled mental states of Angel Dust and Cherri Bomb as they use sex, drugs, and violence to cope with abuse and pain in a cruel world like Hell.
  • The Caretaker is an ambient musician known for exploring the human memory, particularly dementia. His most famous project, Everywhere at the End of Time, is a six-hour-long album best described as the sonic equivalent of losing one's mind, starting with staticky versions of old show tunes and ending with an incomprehensible mess.
  • The music video for The Chemical Brothers' "Believe" (featuring Kele Okereke of Bloc Party) follows a paranoid factory worker hallucinating that the robotic arms he operates are stalking him. The man is eventually chased to the roof of a multi-storey car park by one of the machines, where it corners and lunges at him before... suddenly disappearing. The video ends with the man fully losing his grip on reality, laughing hysterically as he collapses in the street.


    Video Games 
  • American McGee's Alice is a famous example of this, in which the monsters Alice fights are physical representations of her own psychological issues, mostly regarding her survivor's guilt after the death of her family.
  • Alice: Madness Returns, sequel to American McGee's Alice carries on the tradition, adding overhearing but not knowing to stop the rape of her sister to her list of guilts. Unlike the first game, parts of the plot take place in the real world, which then hammer in the horror as the two realms start to bleed together.
  • Anatomy has a very slow Nothing Is Scarier grind in comparing the house you're in to a human mind and body, going on about how important and how deceitful a home can be. The house accommodates itself accordingly.
  • Blackout follows a Player Character with a Split Personality and plenty of Alternate Identity Amnesia, who tries to piece together his own identity, all while trying to get to the bottom of the mystery of the headless body that suddenly appeared in his apartment one night, before disappearing just as mysteriously almost immediately thereafter. Much of it involves his Dark and Troubled Past and Abusive Parents.
  • Call of Cthulhu: Dark Corners of the Earth, naturally, makes heavy use of this trope due to being a first person perspective retelling of the famous "Shadow over Innsmouth" story.
  • Condemned: Criminal Origins explores themes of violent insanity and whether or not the player can trust they aren't going crazy, even as they fight off waves of delusional, psychotic killers.
  • Cry of Fear fits this neatly. The game is focused on exploring the madness of the main character Simon through the environment (which twists and changes whenever Simon has a psychotic fit), enemies (each of which is based on one of Simon's fears and the anger he has about his unusable legs) and flashbacks with his doctor.
  • Dead Space is more of an Action Survival Horror mixture, but the copious use of insanity, both in the player character and in the world around them, vivid and terrifying hallucinations, and recordings of the slow descent of the world into madness before you arrived. All punctuated with the need to brutally rip apart corpses before they turn into horrific monsters and do the same thing to you.
  • Eternal Darkness, especially since one of the three traits in the game is Sanity, alongside vitality and Mana. Not only are you dealing with enemies that defy common logic, they are purposefully distorting your perception of reality. If you beat them they're gone and not only will you be trying to describe something that sounds insane, you probably are insane. Even if the psychological tricks don't scare you, let that sanity bar run out and your vitality will quickly go down the drain.
  • Fatal Frame is a cross between Psychological and Survival Horror, with the overarching story being the protagonists getting trapped in haunted villages and slowly piecing together what ominous events created the various horrific ghosts that will kill them cruelly and painfully if they catch them.
  • F.E.A.R. blends supernatural horror, achieved primarily through unnerving atmosphere rather than any overt monsters, with a scifi-ish tactical shooter set 20 Minutes into the Future.
  • Fran Bow in which the titular character, a young girl, tries to cope with the trauma from witnessing the gruesome murder of her parents, a event so awful that the thought of it regularly causes her perception of reality to break down.
  • Every game developed by Frictional Games, thus far, has made heavy use of this trope:
  • Hellblade: Senua's Sacrifice is very much this, since it deals with Senua, a Shell-Shocked Veteran who suffers from psychosis after losing her lover (and many other misfortunes). Disturbing images are everywhere, Senua is constantly fighting her own demons and voices in her head constantly bicker with each other, making it even harder to determine what is real and what is not.
  • Jim's Computer takes advantage of humanity's paranoia, as it abuses it to its fullest by making the player look through closets late at night each time, increasing tension that one night, something will be inside. It doesn't help that the game has a subplot of multiple people going missing over short periods of time, a nameless stranger with no profile picture messaging you randomly, the visual and auditory hallucinations, a mysterious black square, and Jim expressing his own paranoia that someone is inside his house, and saying that he feels safe again each time you finish checking the closets. All of these things make the player wonder that maybe Jim is right, that maybe something supernatural and malevolent is randomly opening and closing the door and turning on the TV late at night, and hiding in one of the closets as they do it.
  • Imscared toys with the player in a very interesting way of immersion; the game torments you with the prospect that the game's villain is a real entity, and is actively playing around with your computer by downloading text files pretending it's a computer virus. That's right, a real life version of The Most Dangerous Video Game.
  • Iron Storm is a shooter that has zero supernatural elements, but is set in a nigh-nightmarish Diesel Punk world scarred by an increasingly insane and dystopic Forever War.
  • Madison (2022): The player character is alone in his grandfather's house with a haunting supernatural presence.
  • Metro 2033 is a first person shooter, but while it has gunfights against bandits, mutants, and Neo-Nazis and/or Communists, those are brief levels of heart-pounding adrenaline between long stretches of isolation, unexplained but explicitly supernatural horrors such as ghosts and 'anomalies', and a growing sense of gloomy, claustrophobic despair in the tunnels that manages to evolve into agoraphobic paranoia when Artyom is in the open on the surface. Worst of all are some of the completely unexplained instances of blatant and lethal Mind Screw that defy explanation — the less said about the Dark Ones, the better. It's saying something when it's comforting to have a level with Nazis to shoot at, versus the game's alternatives
  • Irwin Segarane's Mother is about a single mother who must protect her two children from paranormal beings that stalk her apartment complex.
  • NEEDY STREAMER OVERLOAD is about helping a girl become internet famous, but should she end up overstressed (or overdosed), the player will be subjected to her resulting mental breakdown and psychotic fits, unable to do anything but watch her fall further and further into madness.
  • Okaeri is stated to be this on its Steam page. This can probably be backed up by the random noises that occur in the game.
  • OMORI is this, particularly during the real world at night via hallucinations and also during the sections inside Blackspace.
  • One of the reasons why the original Operation Flashpoint and its current successor ARMA are praised for their realism is how they not only accurately portray the tech and tactics employed on a modern battlefield, but also the tension, paranoia and uncompromising unpredictability of military operations. Compared to most other military games, which are usually action-pumped thrill rides with lots of loud set pieces, these titles have the player experiencing almost unbearable tension while moving through enemy territory. The enemies can be well hidden, may already know of your position, may be already surrounding you stealthily and killing you before you even manage to register them and realize your grave mistake. And don't even get us started on situations like being Trapped Behind Enemy Lines, completely out of ammo and hiding in the bushes, because heavily armed brigades of soldiers and vehicles are combing the whole area. All of this goes hand in hand with the horror occurring commonly during missions set in broad daylight.
  • Paranoiac is this overlapped with Survival Horror, with grief and mental illness playing large roles in the plot. After moving into her late aunt's house, Miki finds herself being stalked by a monster every night, along with other strange and spooky occurrences, but it soon becomes obvious the underlying conflict is around Miki battling with depression and guilt over her aunt's death. It's even suggested that the monster may not actually be real; real or not, it's implied to represent Miki's inner turmoil and struggle.
  • The Path explores the psyches of a family of sisters by sending them one by one to Grandmother's house— and forces you to disobey and send them into danger by straying from the titular path in order to progress in the game. The eerie ambiance of the forest, the Jigsaw Puzzle Plot wherein you discover each girl's personality by the scraps of her thoughts you see when she interacts with objects, and especially the abstract "wolf encounters" and the twisted state of Grandmother's house afterwards place it firmly here.
  • Pathologic has a thick atmosphere of physical and spiritual decay, manifested through disease, that eats away both the game world and the confidence of the player actually running it.
  • House Beneviento in Resident Evil Village takes this tone compared to the rest of the game, as protagonist Ethan Winters finds himself stripped of his items and is tormented with images, apparitions, and anguished recordings of his wife. This reaches its peak when Ethan finds himself being pursued by a horrific giant baby monster that cannot be fought in any way. Even the boss fight is a rush to find a doll hiding among the other toys rather than the action formula of other bosses, making the house feel more supernatural and ambiguously real, like a mind trip that's deeply personal to Ethan's fears. Indeed, Donna Beneviento, who presides over the house, is revealed to use hallucinogenic powers to torture her victims rather than brute force, and is playing on Ethan's fears after the shooting of his wife and his concerns about his baby's normalcy.
  • Postal's first installment is VERY VERY much this with its harrowing and almost psychedelic loading screens and the protagonists' "war journal" entries elaborating on his mental state/filling in for the story.
  • Prey (2017) has you dealing with breaks from reality, such as your reflection talking to you or hallucinating being consumed by shadowy tendrils.
  • Roots of Insanity: Dr. McClein suffers from epilepsy that causes him to have scary hallucinations. Expect to see zombies and various other horrors pop in and out of existence.
  • Silent Hill: The enemies and environments of each game are pulled from the screwed-up psyche of one or more of its characters, and the series relies far more on Nothing Is Scarier, surreal imagery and symbolism than jump scares and gore. The games occasionally hint that the protagonist may simply be insane.
  • Silent Hill: Shattered Memories in particular relies on psychological horror, since it prefers to downplay the "survival" element. Especially with the reveal that the entire game was literally taking place in one character's mind in response to attempt psychological therapy.
  • Smile is about a guy seeing a doctor for help with his mental health and addictions, only to end up trapped in a strange world, pursued by horrifying beings who want to kill him.
  • Sofia?: The game starts innocuously enough; you play as a man, Crow, on a date with his partner Fio, but things take a turn for the worse as Crow witnesses the murder of Fio the same night. After that night, Crow is locked in what seems to be a "Groundhog Day" Loop where he has to relive Fio being killed again and again, but there seems to be something much more sinister going on under the surface as Crow investigates every avenue and relives the torment of Fio's death.
  • Spec Ops: The Line is a curious example of the trope. It opens much like any other modern military shooter, but about halfway through the game (after the protagonists unwittingly burn forty-seven innocent civilians to death with white phosphorous rounds) it starts to take on more and more elements of psychological horror, including surreal, horrific imagery, hallucinations etc.
  • Subway Midnight is set in a series of subway cars that are being haunted by the ghosts of children, and the protagonist (also a child) has to navigate them while also being stalked by the sinister figure that's responsible for their deaths.
  • The Suffering is a cross between psychological and physical horror. While you will be fighting inmates, guards, and wretched abominations, you will also encounter horrific hallucinations and the ghosts of Carnate Island's insane and psychopathic residents.
  • One or two of the missions of SWAT 4 tackle extremely disturbing crime cases in very creepy locales.
  • When The Darkness Comes is a game that tries to illustrate depression and anxiety through horror visuals.
  • Who's Lila? is a point-and-click adventure game initially concerning the murder of a woman named Tanya, but the pursuit of solving the titular question leads to a David Lynch-inspired thriller.
  • The Works of Mercy is about the protagonist being forced to murder people, or otherwise try desperately to save them while being tormented by an unknown psychopath.

    Visual Novels 
  • While Bad Faith features violence and some sci-fi and fantastical elements, the true horror comes from the idea of being ostracized and dehumanized by your own community, such as the way the Haven treats anyone deemed "insane."
  • Cooking Companions, openly inspired by works such as P.T. and Doki Doki Literature Club as well as actual Eastern European folklore, is a Dating Sim with cutesy mascots that inevitably leads to ominous dread, as the cast is trapped in the mountains with dwindling supplies and there's No Party Like a Donner Party.
  • Doki Doki Literature Club! is a seemingly cheery, innocent Dating Sim that is nevertheless prefixed with a Content Warning about disturbing content. The game turns out to be just as much about real-life issues such as Self-Harm, Abusive Parents and depression as it is an existential horror about a Dating Sim character gaining Medium Awareness and struggling to cope to being a fictional character before rewriting and corrupting the game around her so that she can be with the player.
  • Do NOT Take This Cat Home is a story about a lonely person adopting an adorable kitten, that quickly becomes a story about someone trapped in an abusive relationship with a Yandere Eldritch Abomination who has taken control of their mind and perceptions, and their desperate attempts to escape it.
  • Echo starts off feeling like a subdued college flick that contains an air of realism. We then get a clearer picture of the cast; they are all troubled individuals bound by a traumatic moment in time, the drowning of their childhood friend. The problem is that the Psychological Torment Zone they're in reflects those personal demons back at the cast and shows us how terrifying they can be when left unaddressed. Addressing issues such as mental illness, toxic relationships, personal identity, and freedom, Echo is a story about breaking cycles and overcoming personal demons. Or it can be a story about succumbing to those very same demons depending on your choices.
  • MAMIYA explores the effects of Natsume Souichirou's death on four of his friends. After the funeral, their mental states begin worsening, and each of Natsume's friends meet a mysterious child named Mamiya, who might be a supernatural being or a delusion. Tackling themes of abuse, gender identity, loneliness, and illness, MAMIYA is an exploration of the effects of grief.
  • The When They Cry series is made of this (often mixed with some gore), as the protagonists often succumb to madness and hallucinations or are mentally tortured/have their hopes crushed in various ways.
  • Milk inside a bag of milk inside a bag of milk and its sequel Milk outside a bag of milk outside a bag of milk: Both games follow an unnamed girl with severe mental illness trying to go about her day. The first game is about her going to the store to buy milk and the sequel is about her trying to go to bed when she gets home. Both games feature strange and at times creepy imagery, but the actual horror of the games comes from the very honest message it has about living with mental illness. There is no easy, magical solution to your problems. You can't escape from your own mind, and sometimes the most you can do is to try to get through each day, even if that can seem impossible.
  • Penthos turns into this during the Second Act of the story, as the theme shifts focus from a slasher story to ruminating on death and grief, all the while utilizing a slower pace and more realistic tone that differs from the first half.

  • Gunnerkrigg Court:
    • The comic dips into this any time Zimmy shows up. Her perception of the world is very abnormal—and she has Reality Warper Power Incontinence. So when the focus switches to Zimmy, bizarre, dreamlike events are quick to follow. It's never entirely clear how much of this is real and how much is hallucination... or how much is a hallucination that's becoming real.
    • A non-Zimmy example happens in the chapter "A Ghost Story". Annie has to counsel a ghost—and since the ghost doesn't realize he's dead, he unintentionally creates a shared hallucination that symbolizes an event from his old life.
  • Homestuck delves into this around the middle of Act 5 when Gamzee goes sober and starts killing off the characters, which had already started dying by Eridan and Vriska earlier. Probably the creepiest part is a flash in which, after seeing a few scenes of Nepeta and Equius talking adorably to one another, the reader is forced to play as the both of them and lead them through a dark, deserted lab as ominous music riddled with honks slowly grows louder. The worst part is that, unlike in a video game, the 'player' has no choice - they know the story depends on the two characters moving towards the threat, so unless they just stop reading altogether (which doesn't solve the problem as of course the story continues on regardless) they can't continue any other way than by leading these beloved, oblivious characters to what is likely their doom. And indeed it is.
  • Ghost Teller, a Korean webcomic, delves on this in the majority of the story due to it's titular theme of Humans Are the Real Monsters.

    Web Original 
  • Alien Abduction Role Play has this in spades. The plot concerns that of an alien who is tending to her human test subject, and she bluntly expresses her desire to eat the human protagonist to their face, licking them and tasting them. While she does warm up to the human and fall in love with them, her irrational desire to eat them does not go away, and she slowly becomes more and more unhinged as the series progresses. It becomes clear that this behavior is very abnormal, even for her, and that she was normally very reasonable and nice before encountering the human.
  • A good chunk of vlogs and stories pertaining to The Slender Man Mythos love this trope. As for Marble Hornets, one of the more prominent examples, it's pretty much made of this trope. Well, that and Paranoia Fuel. Lots and lots of that, too.
  • This trope, Surreal Horror, and Paranoia Fuel are the backbone of most creepypastas.
  • Division by Zero never lets its readers forget that no matter how strong the characters are (with most, if not all the cast capable of destroying planets as a baseline), the mind is a fragile thing. Emotional and psychological vulnerabilities and primal survival are a constant in its narration. Fear of death, fear of life, fear of failureit doesn’t pull punches. Early on the protagonist deals with a deeply traumatic event, an identification too close to home, two haunting questions: Will they ever recover? Can they ever recover? It does not shy away from suicide and we are walked through it, thoughts and all, attempt after attempt, each time raw and visceral. It is both profound and unnerving all at once, children mercilessly thrown into a cosmic war they have no business fighting—they can barely take care of themselves. It promises the gritty details into an inevitable descent into insanity (or several), and the plummeting feeling of jumping from gut-wrenching heights, and that is to say nothing of the Eldritch Horror of it all.

    Western Animation 
  • Adventure Time uses this fairly frequently. Most notably, anything having to do with the Ice King's past is either going to be this or a Tear Jerker.
  • The second-to-last episode of BoJack Horseman's fourth season is seen entirely from the point-of-view of BoJack's mother, Beatrice, who, suffering from dementia, is incapable of differentiating the present and her various memories, and relives all of the shitty events that shaped her to the woman she is.
  • The 2018 reboot of She-Ra and the Princesses of Power features this, especially in season 4.
    • "Hero" reveals why Razz seems senile. She's being shunted back and forth between two different time periods at random moments. She gets confused as to what time period she's in and whether she's talking to Adora or Mara. Her disorientation at being toggled between two different time periods can be interpreted as an allegory for dementia.
    • Beast Island, the island to which the Horde exiles powerful enemies and screw-ups, wears away visitors' willpower by preying on their deepest pain and insecurities. Vines then absorb visitors who have lost the will to resist.
    • Horde Prime uses mind control to deny his clones free will, personalities, and even names. He's capable of entering their minds and probing their most intimate memories. Most frightening of all, he can perform a mind-wipe on any of his clones, as he does to Hordak at the end of season 4.


Video Example(s):


The Medium

The Medium is a supernatural horror puzzle adventure game developed and published by Bloober Team, with its musical score co-composed by Akira Yamaoka of Silent Hill fame. It was released worldwide for Microsoft Windows and the Xbox Series X/S on January 28, 2021.

The story follows Marianne, a woman with the ability to perceive and interact with the Spirit World and the ghosts that live there. When a phone call from a stranger promises her the truth of the origins of her powers, she finds herself at the Niwa, an empty decrepit hotel outside of Krakow, Poland. However, Marianne quickly realizes that something is wrong and must unravel the mystery behind its abandonment - if the nightmarish monsters infesting the place don't kill her first.

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